Recognition of the magnitude of the problem and the means of evaluating for peer victimization is important for clinicians who work with overweight youth. Assessing peer experiences may assist in understanding rates of physical activity and/or past nonadherence to clinician recommendations.

This study sought to examine quality of life (QoL) in clinic-referred children and adolescents (n = 59, M age = 11.4+/-2.6 years) with a chronic tic disorder. The QoL scores for tic patients were lower than for healthy controls but higher than for the psychiatric sample on the majority of domains. Children's self-reported QoL scores and a measure of tic severity were moderately and inversely correlated. Parent reports of their child's QoL were weakly related to tic severity. Correlations between parent and child ratings of QoL for children ages 8 to 11 years were generally higher than those for youth ages 12 to 17 years. Finally, externalizing behavior moderated the relations between tic severity and parent-rated QoL, such that tic severity was significantly associated with parent-rated QoL for children with below average externalizing symptoms but not for children 3with above average externalizing symptoms.

Background:Obesity and a sedentary lifestyle are associated with physical impairments and biologic changes in older adults. Weight loss combined with exercise may reduce inflammation and improve physical functioning in overweight, sedentary, older adults. This study tested whether a weight loss program combined with moderate exercise could improve physical function in obese, older adult women.Methods:Participants (N = 34) were generally healthy, obese, older adult women (age range 55–79 years) with mild to moderate physical impairments (ie, functional limitations). Participants were randomly assigned to one of two groups for 24 weeks: (i) weight loss plus exercise (WL+E; n = 17; mean age = 63.7 years [4.5]) or (ii) educational control (n = 17; mean age = 63.7 [6.7]). In the WL+E group, participants attended a group-based weight management session plus three supervised exercise sessions within their community each week. During exercise sessions, participants engaged in brisk walking and lower-body resistance training of moderate intensity. Participants in the educational control group attended monthly health education lectures on topics relevant to older adults. Outcomes were: (i) body weight, (ii) walking speed (assessed by 400-meter walk test), (iii) the Short Physical Performance Battery (SPPB), and (iv) knee extension isokinetic strength.Results:Participants randomized to the WL+E group lost significantly more weight than participants in the educational control group (5.95 [0.992] vs 0.23 [0.99] kg; P < 0.01). Additionally, the walking speed of participants in the WL+E group significantly increased compared with that of the control group (reduction in time on the 400-meter walk test = 44 seconds; P < 0.05). Scores on the SPPB improved in both the intervention and educational control groups from pre- to post-test (P < 0.05), with significant differences between groups (P = 0.02). Knee extension strength was maintained in both groups.Conclusion:Our findings suggest that a lifestyle-based weight loss program consisting of moderate caloric restriction plus moderate exercise can produce significant weight loss and improve physical function while maintaining muscle strength in obese, older adult women with mild to moderate physical impairments.

ObjectiveTo examine the contributions of frequency, consistency, and comprehensiveness of dietary self-monitoring to long-term weight change.Design and MethodsParticipants included 220 obese women (mean±SD, age=59.3±6.1 years; BMI=36.8±4.9 kg/m2) who achieved a mean loss of -10.39±5.28% from baseline during 6 months of behavioral treatment and regained 2.30±7.28% during a 12-month extended-care period. The contributions of cumulative frequency (total number of food records) of self-monitoring, consistency across time (number of weeks with ≥3 records), and comprehensiveness of information recorded were examined as predictors of weight regain in a hierarchical linear regression analysis The mediating role of adherence to daily caloric intake goals was tested using a bootstrapping analysis.ResultsThe association between high total frequency of self-monitoring and reduced weight regain was moderated by weekly consistency of self-monitoring, p=.004; increased frequency produced beneficial effects on weight change only when coupled with high consistency (>3 days/week). There was no impact of comprehensiveness on weight change, p>.05. The favorable effect of high frequency/high consistency self-monitoring on weight change was partially mediated by participants’ success in meeting daily caloric intake goals (p< .001).ConclusionThe combination of high frequency plus high consistency of dietary self-monitoring improves long-term success in weight management.

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ObjectiveTo evaluate the effects and costs of three doses of behavioral weight-loss treatment delivered via Cooperative Extension Offices in rural communities.Design and MethodsObese adults (N=612) were randomly assigned to low, moderate or high doses of behavioral treatment (i.e., 16, 32 or 48 sessions over two years) or to a control condition that received nutrition education without instruction in behavior modification strategies.ResultsTwo-year mean reductions in initial body weight were 2.9% (95% Credible Interval=1.7–4.3), 3.5% (2.0–4.8), 6.7% (5.3–7.9), and 6.8% (5.5–8.1) for the control, low, moderate, and high-dose conditions, respectively. The moderate-dose treatment produced weight losses similar to the high-dose condition and significantly larger than the low-dose and control conditions (posterior probability > .996). The percentages of participants who achieved weight reductions ≥ 5% at two years were significantly higher in the moderate-dose (58%) and high-dose (58%) conditions compared with low-dose (43%) and control (40%) conditions (posterior probability > .996). Cost-effectiveness analyses favored the moderate-dose treatment over all other conditions.ConclusionA moderate dose of behavioral treatment produced two-year weight reductions comparable to high-dose treatment but at a lower cost. These findings have important policy implications for the dissemination of weight-loss interventions into communities with limited resources.Trial RegistrationClinicalTrials.gov number, NCT00912652.

Little is known about the cardiovascular effects of modest weight loss. To determine whether weight losses limited to 5-10 % are sufficient to produce cardiovascular health benefits, data from 401 overweight and obese adults who enrolled in a behavioral weight loss program from 2003 to 2011 were analyzed. Primary outcomes were changes in fasting glucose, triglycerides, and cholesterol. Patients who lost 5-10 % showed significant reductions in triglycerides, total cholesterol, and low-density lipoprotein (LDL) cholesterol. Patients who lost >10 % experienced significantly greater improvements in triglycerides, total cholesterol, and LDL cholesterol than patients losing less. For higher-risk patients, those who lost 5-10 % significantly reduced fasting glucose, triglycerides, and total cholesterol; those who lost >10 % improved on all risk factors (except HDL cholesterol) and to a significantly greater degree than those losing less. Five to 10 % weight losses produced improvements in cardiovascular risk factors, but greater weight losses were associated with even greater improvement.

BackgroundFew investigations of successful long-term weight loss beyond two years have been conducted, and none has examined weight changes in medically underserved rural populations of older adults. The purpose of this study was to assess long-term weight loss maintenance 3.5 years after the completion of an initial six-month lifestyle intervention for obesity among women aged 50–75 years residing in rural communities.MethodsOne hundred and ten obese women with a mean (± standard deviation) age of 60.08 ± 6.17 years and mean body mass index of 36.76 ± 5.10 kg/m2 completed an in-person assessment during which their weight and adherence to behavioral weight management strategies were evaluated.ResultsParticipants showed a mean weight reduction of 10.17% ± 5.0% during the initial six- month intervention and regained 6.95% ± 9.44% from the completion of treatment to follow-up assessment 3.5 years later. A substantial proportion of participants (41.80%) were able to maintain weight reductions of 5% or greater from baseline to follow-up. “Successful” participants (those who maintained losses of 5% or greater at follow-up) reported weighing themselves, self-monitoring their intake and calories, planning meals in advance, and choosing lower calorie foods with greater frequency than “unsuccessful” participants (those who lost less than 5%).ConclusionCollectively, these findings indicate that a large proportion of participants were able to maintain clinically significant weight losses for multiple years after treatment, and that self-monitoring was a key component of successful long-term weight management.